How much rates vary
Facilitymedian $98 · 10th to 90th $83 to $162Professionalmedian $87 · 10th to 90th $41 to $3,715
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | None | $74.13 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $36.31 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $14.79 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $10.96 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.41 | $8.71 | $8.71 |
BCBS Idaho Setting Facility Modifier None Typical Low $74.13 Median $97.72 Typical High $162.18 | Facility | None | $74.13 | $97.72 | $162.18 |
BCBS Idaho Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Moda Health Setting Facility Modifier None Typical Low $81.28 Median $87.10 Typical High $125.89 | Facility | None | $81.28 | $87.10 | $125.89 |
Moda Health Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $107.15 | Professional | None | $81.28 | $87.10 | $107.15 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $40.74 | $43.65 | $43.65 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.22 | $17.38 | $17.38 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.30 | $13.18 | $13.18 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.13 | $8.71 | $8.71 |
Molina Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $48.98 | Professional | None | $41.69 | $41.69 | $48.98 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $6,025.60 | Facility | None | $125.89 | $125.89 | $6,025.60 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $25.12 Median $125.89 Typical High $7,079.46 | Professional | None | $25.12 | $125.89 | $7,079.46 |
Regence BlueShield Setting Facility Modifier None Typical Low $95.50 Median $97.72 Typical High $144.54 | Facility | None | $95.50 | $97.72 | $144.54 |
Select Health Setting Facility Modifier None Typical Low $93.33 Median $102.33 Typical High $128.82 | Facility | None | $93.33 | $102.33 | $128.82 |
Select Health Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $199.53 | Professional | None | $87.10 | $102.33 | $199.53 |
United Setting Professional Modifier None Typical Low $10.96 Median $40.74 Typical High $43.65 | Professional | None | $10.96 | $40.74 | $43.65 |
1 more rate with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
BCBS Idaho Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $74.13 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $74.13 | $74.13 | $77.62 |
Where Idaho sits
The same service costs 3.2 times more in Hawaii than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Idaho· 7th of 51
$87.10
HI $135NY $41.69
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.